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Pediatric spinal cord diffuse midline glioma with H3 K27M-alteration with leptomeningeal dissemination: a rare case with intracranial hypertension onset and no spinal cord-related symptom

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Abstract

Purpose

Spinal cord diffuse midline glioma (DMG) with H3 K27-alteration is a group of spinal cord high-grade glioma with poor outcome. We present a case with rare onset symptom pattern of pediatric spinal DMG, contributing to the understanding of the clinical presentations and natural history of pediatric spinal cord DMG.

Methods and results

A 7-year-old boy was admitted due to symptoms of intracranial hypertension without obvious spinal cord-related symptoms. Head radiological examinations, blood and cerebral spinal fluid tests did not support intracranial lesion, infection, or autoimmune diseases. Spinal magnetic resonance imaging revealed intraspinal occupying lesion with leptomeningeal dissemination. Pathology of the lesion verified DMG with H3 K27M-alteration.

Conclusion

Pediatric DMG with leptomeningeal dissemination could present with initial symptoms of intracranial hypertension without obvious spinal cord-related symptoms. Spinal cord examinations in cases of intracranial hypertension with negative head radiological examination results could be valuable in finding the etiology.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Yutong Liu and Peng Sun contributed equally to this article.

Authors and Affiliations

  1. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China

    Yutong Liu, Peng Sun, Mading Zhou, Jianxin Du & Gao Zeng

Authors
  1. Yutong Liu
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  2. Peng Sun
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  3. Mading Zhou
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  4. Jianxin Du
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  5. Gao Zeng
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Contributions

YTL and PS: Conceptualization, collecting data, writing original draft preparation. MDZ: Preparing figure. JXD: Supervision. GZ: Conceptualization, writing review and editing, supervision. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Gao Zeng.

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Ethics approval and consent to participate

The present study was approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University. All procedures were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from the legal guardian of the patient. 

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The authors declare no competing interests.

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Liu, Y., Sun, P., Zhou, M. et al. Pediatric spinal cord diffuse midline glioma with H3 K27M-alteration with leptomeningeal dissemination: a rare case with intracranial hypertension onset and no spinal cord-related symptom. Childs Nerv Syst 39, 1663–1666 (2023). https://doi.org/10.1007/s00381-023-05851-1

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